Intra uterine growth retardation (IUGR) due to fetoplacental vascular insufficiency is rampant in developing countries like India. Owing to the lack of awareness, antenatal patients often present in their third trimester for their first ultrasound examination. Alterations in the wave forms and Doppler indices of fetal middle cerebral artery (MCA), umbilical artery and been extensively described in various studies in the literature. However, the role of each doppler parameter in actually predicting reduced birth weight (for gestational age) in the third trimester is often debatable and frustrating. Method: A prospective study was done on 500 patients of clinically suspected IUGR highrisk pregnancies of 28weeks onwards pregnancy. The cases were followed till delivery; the doppler and grey scale findings. Result: All cases were followed up for perinatal outcome. Adverse perinatal outcome included low birth weight (<2.5 kg), preterm delivery, APGAR score <7 at 5min, admission to the NICU and perinatal mortality. Raised umbilical artery indices had 74% Sensitivity and 94% Specificity in predicting adverse perinatal outcome. Raised MCA indices had 80% Sensitivity and 95% Specificity in predicting adverse perinatal outcome Reversed cerebroumbilical ratio had 85% Sensitivity and 98.7% Specificity in predicting adverse perinatal outcome Absent end diastolic flow or reversed end diastolic flow had 88.8Sensitivity and 100% Specificity in predicting adverse perinatal outcome With the presence of abnormal Doppler indices, chances of operative intervention in form of caesarean section increases. Conclusion: Doppler ultrasound is a safe and noninvasive hemodynamic tool for assessing foetal well being and prediction of adverse perinatal outcome in clinically IUGR pregnancies. A combination of umbilical artery and middle cerebral artery Doppler study helps to identify foetus at risk for morbidity and mortality so that appropriate obstetric intervention required can be done timely so as to reduce perinatal morbidity and mortality.

Keywords: Uterine; Intrauterine growth restriction (IUGR).